Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI

Patients with ST-elevation MI (STEMI) usually have a huge thrombus burden in the infarct-related artery. Stenting may lead to high chances of the slow-flow/no-reflow phenomenon that leads to periprocedural MI and adverse cardiovascular events. Deferred stenting may be beneficial in this situation as...

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Autores principales:	Akshyaya Pradhan, Monika Bhandari, Pravesh Vishwakarma, Rishi Sethi
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/833dfe9d71d24cb88434992f95c3e93a
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spelling	oai:doaj.org-article:833dfe9d71d24cb88434992f95c3e93a2021-12-04T16:04:08ZDeferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI10.15420/ecr.2020.311758-37641758-3756https://doaj.org/article/833dfe9d71d24cb88434992f95c3e93a2021-03-01T00:00:00Zhttps://www.ecrjournal.com/articleindex/ecr.2020.31https://doaj.org/toc/1758-3756https://doaj.org/toc/1758-3764Patients with ST-elevation MI (STEMI) usually have a huge thrombus burden in the infarct-related artery. Stenting may lead to high chances of the slow-flow/no-reflow phenomenon that leads to periprocedural MI and adverse cardiovascular events. Deferred stenting may be beneficial in this situation as the thrombus burden will reduce, mitigating the slow-flow/no-reflow phenomenon. However, routine deferral of stenting in patients with STEMI has not been found to be beneficial, but when the patient is properly selected, deferred stenting has the potential for reducing the final infarct size. The authors report the safety and feasibility of deferred stenting after 5 days of prolonged anticoagulation in a 45-year-old smoker with STEMI who had a large thrombus load shown on an angiogram. They review the registries, trials and meta-analyses on deferred stenting in the literature and analyse the benefits and harms of the strategy. They also propose an algorithm for applying a strategy for deferred stenting in clinical practice based on the available data.Akshyaya PradhanMonika BhandariPravesh VishwakarmaRishi SethiRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENEuropean Cardiology Review , Vol 16, Iss , Pp - (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Akshyaya Pradhan Monika Bhandari Pravesh Vishwakarma Rishi Sethi Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI
description	Patients with ST-elevation MI (STEMI) usually have a huge thrombus burden in the infarct-related artery. Stenting may lead to high chances of the slow-flow/no-reflow phenomenon that leads to periprocedural MI and adverse cardiovascular events. Deferred stenting may be beneficial in this situation as the thrombus burden will reduce, mitigating the slow-flow/no-reflow phenomenon. However, routine deferral of stenting in patients with STEMI has not been found to be beneficial, but when the patient is properly selected, deferred stenting has the potential for reducing the final infarct size. The authors report the safety and feasibility of deferred stenting after 5 days of prolonged anticoagulation in a 45-year-old smoker with STEMI who had a large thrombus load shown on an angiogram. They review the registries, trials and meta-analyses on deferred stenting in the literature and analyse the benefits and harms of the strategy. They also propose an algorithm for applying a strategy for deferred stenting in clinical practice based on the available data.
format	article
author	Akshyaya Pradhan Monika Bhandari Pravesh Vishwakarma Rishi Sethi
author_facet	Akshyaya Pradhan Monika Bhandari Pravesh Vishwakarma Rishi Sethi
author_sort	Akshyaya Pradhan
title	Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI
title_short	Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI
title_full	Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI
title_fullStr	Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI
title_full_unstemmed	Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI
title_sort	deferred stenting for heavy thrombus burden during percutaneous coronary intervention for st-elevation mi
publisher	Radcliffe Medical Media
publishDate	2021
url	https://doaj.org/article/833dfe9d71d24cb88434992f95c3e93a
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Deferred Stenting for Heavy Thrombus Burden During Percutaneous Coronary Intervention for ST-Elevation MI

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